DermNet provides Google Translate, a free machine translation service. Note that this may not provide an exact translation in all languages
Home » Topics A–Z » Tumour necrosis factor inhibitors
Tumour necrosis factor inhibitors
What are tumour necrosis factor inhibitors ?
Tumour necrosis factor (TNF) is a cytokine associated with inflammatory disorders of the skin, joints, and gastrointestinal tract.
The most active tumour necrosis factor inhibitors (anti-TNF drugs) are monoclonal antibodies targeted against TNF-alpha (TNFα). Anti-TNFα drugs control inflammation in inflammatory skin diseases, arthritis, and bowel disease. They were among the first biologic agents on the market.
Anti-TNFα monoclonal antibodies include:
- Infliximab
- Adalimumab
- Etanercept
- Golimumab
- Certolizumab.
Other compounds with anti-TNF activity
Other drugs with activity against TNF include:
- Thalidomide
- Sulfasalazine
- Pentoxifylline
- Bupropion.
Natural compounds acting against TNF include:
- Catechins
- Curcumin
- Cannabinoids
- Echinacea purpurea.
What skin conditions are tumour necrosis factor inhibitors used to treat?
The anti-TNF monoclonal antibodies are used mainly in the treatment of severe chronic plaque psoriasis.
They are also used for other severe inflammatory skin diseases when conventional therapies have failed. Examples include:
- Hidradenitis suppurativa
- Skin disease associated with Crohn disease
- Pyoderma gangrenosum and PAPA syndrome (off-label).
Skin conditions treated with tumour necrosis factor inhibitors
What are the risks of tumour necrosis factor inhibitors use?
Anti-TNF biologics are given by injection. They can sometimes cause injection site reactions or infusion reactions.
They should be avoided in patients with severe heart failure.
The main risk of anti-TNF therapy is reduced immunity to bacterial, fungal, viral, and parasitic infections, including:
They may also increase the risk of developing skin cancers and autoimmune diseases, including demyelinating conditions.
Anti-TNF medicines can lose their effect over time, possibly because of the induction of antibodies against them. Paradoxically, anti-TNF drugs can sometimes result in dermatological side effects, such as:
- Palmoplantar pustulosis
- Various forms of psoriasis
- Eczema
- Lupus erythematosus
- Morphoea
- Alopecia areata
- Vitiligo
- Granuloma annulare
- Sarcoidosis
- Erythema multiforme
- Vasculitis
- Stevens-Johnson syndrome — toxic epidermal necrolysis
- Drug-induced nummular dermatitis
Dermatological side effects of tumour necrosis factor inhibitors
See smartphone apps to check your skin.
[Sponsored content]
Related information
References
- Cordoro KM, Feldman SR. TNF-alpha inhibitors in dermatology. Skin Therapy Lett. 2007 Sep;12(7):4-6. Review. PubMed PMID: 17940711
- Cozzani E, Larosa M, Parodi A. Skin manifestations associated with anti TNF-α therapy.
- Anti-TNF-α Agents in the Treatment of Immune-mediated Inflammatory Diseases: Mechanisms of Action and Pitfalls. Medscape
On DermNet NZ
Other websites
- Psoriasis: TNF inhibitors general recommendations – American Academy of Dermatology
- IBD: Skin Issues From Anti-TNF Therapy Should Be Addressed – Medscape
Books about the skin
See the DermNet NZ bookstore.
Note:
The New Zealand approved datasheet is the official source of information for this prescription medicine, including approved uses and risk information. Check the New Zealand datasheet on the Medsafe website.